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HomeMy WebLinkAboutBP21-269PERMIT # / QI " Q / DATE: O ! / EXP; /p 4=)a z)---- SECTION % BLOCK LOT TYPE OF WORK Q C C of kq/-$ JOB LOCATION t S OWNER 2ri d q �n C 6=m)a aw CONTRACTOR_ s�SQ�I/Q�•�� r4�i ho(9�y)c)3 7L 06Y3 /EST. COST +�3, '7 50 FEE '✓CO # FEES / /Q- P 6 DATE TCO # FEE DATE_____r,____....., INSPECTION RECORD I DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING RGH PLUMBING GAS 0 SPRINKLER ELECTRIC LOW -VOLT CI ALARM U AS BUILT C7 FINAL OTHER APPROVALS I ARB � BOT PB IZBA pTHFR (I'tyy 4yE DR 'M. VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Paul S. Rosenberg (914) 939-0668 Christopher J. Bradbury www.ryebrook.org TRUSTEES BUILDING & FIRE Susan R. Epstein INSPECTOR Stephanie J. Fischer Michael J. Izzo David M. Heiser Jason A. Klein CERTIFICATE OF COMPLIANCE November 15,2021 Friendly Frog Inc. 185 Ivy Hill Crescent Rye Brook,New York 10573 Re: 185 Ivy Hill Crescent, Rye Brook,New York 10573 Parcel ID#: 129.76-1-28 Building Permit#21-269 issued on 10/20/2021 for Replacement Skylights This certifies that the new skylights,installed under the above captioned permit have been satisfactorily completed. Sincerely, Michael J. Izzo Building&Fire Inspector Ag E D D E C IE M BUILD EAR ENT For office u nl : PERMIT# —. 09 NOV _9 2021 VIL OF RYF BROOK ISSUED:/O-QQ-Q 1 938 KING STRE �� F BROOI:,��YORK 10573 DATE: VILLAGE OF RYE BRG4K 939-0668 FEE:ffi f/p 1 PAIDJK BUILDING DEPARTMENT t+ k. it APPLICATION FOR CERTIFICATE OF OCCUPANCY,CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION ***rt*rsrrsasstrtsstarts:assas»assssrtesrrsr#ass#ssrt*st**tstr*arsstsssssssrsasassa•asasassar»as»»s»r»»a»ar####ss#rtsssssssrs Address:_r/ / Hid- cergc,-: T Occupancy/Use: Parcel ID#: l 9. 7� 246 Zone: Owner: Pjauw 1Ajc- Address: Xwttae ,96. ► , j�.y /GSA T P.E./R.A.or Contractor: 4-SBAQ f ,!�f= I=<dC46i Address: Person in responsible charge: skF� K A Address: GcL-►9N Dgrd G�35F STAB Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YORK,COUNTY OF WESTCHESTER as: ��la MI l qV A4!wV I`Wteing duly sworn,deposes and says that he/she resides at& Relw4a I- ow- (Print Name of Ap icant) (No and Street) in ,in the County of in the State of ,that (City(fown/Village) he/she has supervised the work at the location indicated above,and that the actual total cost of the work,including all site improvements, labor,materials,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:S 356G' for the construction or alteration of: 21_ SKYC 101'X rer PG'9G 1 7� Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per§250-10.A.of the Code of the Village of Rye Brook. Sworn to before me this p 7h f� ,! Sworn to before me this day of , 20 [ day of , 20aL Signature of Property Owner Signature of Applicant +fir ARM' ' sh _164H P Print Name oftProperty Owner Print Name of Applicant Notary—Public Notary Public CATHERINE C DUNNE NOTARY PUBLIC s/lzr_czl State of Connecticut My Commission Expires 3/31/2023 BRC��. 198,2 BUILDING DEPARTMENT BUILDING INSPECTOR ❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 W Ww ryebrooLorg - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - -- - - -- -- - - - - - - -- ADDRESS: )U\-/aN DATE: PERMIT# 'y 1 z I l��-{ ISSUED: 7 ECT: BLOCK: LOT: r LOCATION: L C ~Tt L OCCUPANCY: �I J ❑ VIOLATION NOTED THE WORK IS... D^ ACCEPTED © REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION NATURAL GAS L.P. GAS FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ,o/FINAL �J OTHER r Building Permit Check List&Zoning Analysis Address: -s:- V L T C C SBL: i 2f , 7 Co -- I ` Z Zone: ]Use: - t Coast.Type: Other. Submittal Date: 1 D t `L f Revisions Submittal Dates: Applicant: r t' t�r�b G -7.n Nature of Work: �z t L l S Reviews:ZBA: PB: BOT: Other. 'IF OK ( _ ( ) FEES:Filing. 7s, 4, BP: '9J. rT, C/O: Legalization ( ) (4 APP: Dated Notarized ✓ SBL Truss I.D. Cross Connection: H.O.A.: ( } ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO:Long Short Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection S/W Mgmt.: Tree Plan: Other. ( ) ( } SURVEY:Dated: Current Archival: Sealed: Unacceptable- PLANS.Date Stamped Seale Copies: Electronic Other. (►� ( } License:_,Z Workers Comp: Liability Comp.Waiver Other. ( } ( } CODE 753#: Dated: N/A: ( ) ( } HIGH-VOLTAGE ELECTRICAL: Plans: Permit N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL Plans: Peunit N/A: Other: ( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plan: Permit H.W.I.C.:—Battery:_Other. ( } ( ) PLUMBING Plans: Permit: Nat.Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:PLams: Permit N/A Other. ( ) ( } H.V.A.C.: Plans: Permit: N/A: Other. ( ) ( ) FUEL TANK:Plans: Permit: Fuel Type: Other. ( ) ( ) 2020 NY State ECCC: N/A: Other. ( ) ( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( � BP DENIAL LETTER C/O DENIAL LETTER Other. ( ) ( ) Other: ( }ARB mtg.date: approval- notes: ( }ZBA mtg. date: approval- notes { }PB mtg.date: approval: notes: APPROVED REQUIRED EXLLS'I'�ING PRQPQSED NOTES Am pate: OCR 1 9 , ],_ EOW Main Accs. Fr_HISb: Sd.H10L Imp .sue►: Stones: notes; Laura Petersen From: Laura Petersen Sent: Tuesday, October 19, 2021 11:11 AM To: SKAHAN@ INTERSTATE LUMBER.COM Subject: BuiAng Permit Application - 185 Ivy Hill Crescent Good morning, The building permit application has been approved by the Building Inspector. Before I can issue the building permit the following items must be submitted to our office, General contractor's contact name & phone number.'JoSP-4A6s-Qr7j-#p (4?1J/)�7— A. Copy of general contractor's valid Westchester County Home Improvement License. 0&;?3 ,/''3. General contractor's valid liability insurance (the Village Of Rye Brook must be the certificate holder) V/4. General contractor's valid workers compensation on a NY State Board form (C105-2 or U26.3) Thank you Laura .Laura Petersen Office Assistant Village of Rye Brook 938 King Street Rye Brook, New York 10573 Phone(914)939-0668 1 Fax(914)939-5801 1 Ipetersen(o)ryebrook.org 1 A p _ n 04 .. 4 E N o = cs 1 •s �' � Y � � c � ' � v L r.eui as t=! Z_ rn U) Z Q © QU Qto > rs W U .o . D Z w ai a G »a' p Y 3 19 w o ra ,� Q a .y ue e(3 �y 4. i.e ~ U) O C por» 0 z V Ln u7 V r , U Q �r l�S�• .i _ vi I � y 1 ACC>R� CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDfY-"Y)F10/19/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER 914-600_6222 800-860-1151 REACT Philip Christe Philip Christe Insurance M.N nai: 914-600-6222 FAX L c No): 800-860-1151 1 New King Street,#101 AADDRESS.phil@chdsteins.com INSURE S AFFORDING COVERAGE NAICE West Harrison NY 10604 INSURER A: Evanston Insurance Company 36378 '"SURE° 914-237-0683 914-2370937 wuRme.- Pro ressive Casual1y insurance 24260 J. Salvatore &Sons, Inc. INSURER C.. 1187 Yonkers Avenue INSURERD; INSURER E Yonkers NY 10704 INSURERF; COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. U POLICY EFF POLICY EXP -- T$RR TYPE OF INSURANCE yrM POLICY NUMBER MID° _ 0AMADIDFfYYn LOUTS ✓ COMMERCIALGENERALLIABLffY ✓ EACHOCCURRENCE $ 1 00O 000 A 5 RENTED CLXMS-MADE ✓�OCCUR PREMISES Ea occurrence) $ 100 000 3AA470458 04/20/2021 04/20/2022 MED EXP(Any one person s 5 000 PERSONAL d ADV INJURY $1,000,000 _ GIENt AGGREGATE LIMIT APPLIES PER., GENERAL AGGREGATE s2,000,000 POLICY 7v]JECT F-1 LOG PRODUCTS-COMPIOP AGG $1 000 000 OTHER. S AUTOMOBILE LILIABILITYAU ANY AUTO (EsBSI SDI IN LIMIT $500 000 040010160 09102/2021 09/02/2022 BODILY INJURY(Per person) S B OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PR ✓ AUTOS ONLY AUTOS ONLY TY p' 'GE $ —1 L .$ 4UMBRELLA LIAR �]OCCUR EACH OCCURRENCE S EXCESS UAB CLAIMS-MADE AGGREGATE S DED RETENTION WORKERS COMPENSATION PER AND EMPLOYERS'LIABILI Y YIN ST. LITE ER ANYPROPR IETO RIPARTN ERIEXECUTTVE OFFICERIMEMBER EXCLUDED? -INIA E.L.EACH ACCIDENT S (mandatory In u E.L.DISEASE-EA EMPLOYEE S M y��dssalbe under _ !DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,AddMonal Remarks SchedUle,may be attached If more apace Is required) RE: 185 Ivy Hill Crescent Certificate holder is included as additional insured per written agreement subject to policy terms and conditions. CERTIFICATE HOLDER CANCELLATION Village of Rye Brook Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 938 King St. ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook, NY 10573 AUTHORIZED REPRESENTATIVE O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD NEW Workers' CERTIFICATE OF YORK 57ATE Compensation NyS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured J Salvatore&Sons Inc. 914.237.0683 1187 Yonkers Ave. 1 c. i Unemployment Insurance Employer Registration Number of Yonkers, NY 10704 Insured Work Location of Insured(Only required if coverage is specifically limited to 1 d. Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 13-3872277 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) New York State Insurance Fund Village of Rye Brook 3b.Poiicy Number of Entity Listed in Box"I a" Building Department, 14579296 938 King Street, Rye Brook, NY 10573 3c. Policy effective period 01/01/2021 to 0110112022 3d.The Proprietor,Partners or Executive Officers are ❑ Included.(only check box if all partners/officers included) x0 all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"I a"for workers' compensation under the New York State Workers'Compensation Law. (To use this form, New York(NY) must be listed under item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box°2". The insurance carrier must notify the above certificate holder and the Workers' Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in box"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'compensation policy indicated on this form„if the business continues to be named on a permit, license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Gary McCarthy (Print name of authorized representative or licensed agent of insurance tamer) y Approved by: 1 011 9/20 21 (Signature) (Date) Title: Licensed Agent Telephone Number of authorized representative or licensed agent of insurance carrier: 845-878-9293 Please Note:Only insurance carriers and their licensed agents are authorized to issue Form C-105.2.Insurance brokers are NOT authorized to issue it. C-185.2 (9-17) www.wcb.ny.gov